Although the numbers of HIV infection during the perinatal period in the United States have continued to decline over recent decades, its prevalence rates in female adults and adolescents continues to rise, according to study results published in Women & Health.
It is estimated that approximately 5000 women living with HIV give birth every year. With high rates of reported HIV infection cases, Florida was 1 of the first states to authorize comprehensive legislation addressing HIV/AIDS that aimed to promote patient-initiated HIV testing. Between 2007 and 2014, only 57% of mothers with HIV knew their HIV status before pregnancy, 16% during pregnancy, 7% at delivery, and 19% after birth. Further, of the 2444 reported pediatric cases in Florida, 95% were perinatally acquired. However, publicly funded reports for HIV testing do not focus on pregnant women, and information examining HIV testing site types in pregnant women is limited. Therefore, this cross-sectional study identified demographics, HIV risk, and testing behaviors in pregnant women and compared those characteristics across HIV testing sites in Florida.
De-identified data from the Florida HIV Counseling and Testing Database were used. A total of 24,836 women who reported data on demographics and risk behavior information, responded “yes” to being currently pregnant, were age ≥13 years, and were tested for HIV in publicly funded HIV counseling and testing sites in Florida during 2012 were included. Researchers noted that the data set was of testing events; therefore, it may be possible that some women were tested more than once in a given year, resulting in an individual being represented more than once in the dataset. Risk factors were categorized as either personal or partner risk. Descriptive analyses were first performed of demographic characteristics, reported risks, history of previous HIV testing, and HIV test results.
HIV testing records in Latinas comprised the largest proportion of HIV testing events (41.1%), which is greater than their respective nonpregnant counterpart population in Florida (21.9%); 27.4% were non-Hispanic black, 26.7% were non-Hispanic white, 2.7% had no recorded race or ethnicity, and 2.1% belonged to “other” race or ethnicity. Personal risk was more frequently reported among testing records from non-Hispanic white women (9.6%) and non-Hispanic black women (9.1%) compared with Latinas (3.0%; P <.0001). Partner risk was more likely to be reported by non-Hispanic white women than non-Hispanic black women or Latinas. Further, both personal (41.6%) and partner (32.6%) risk behaviors were greatest in women tested at drug treatment sites (28.8%) and prison/jail sites (12.2%). When risks were examined independently, drug treatment site records had the highest reporting records (16.4%) of anal/vaginal/oral sex for drugs/money/other items and injection drug use (31.9%); STD clinic sites had the highest percentage of STD diagnoses (17.2%). Finally, of the 45 positive test results, 42.4% were at prenatal care sites; however, prenatal care sites had the lowest percentage (0.1%) among all testing sites.
Overall, the study authors concluded that, “An understanding of HIV risk and testing behaviors among pregnant women by site type may enhance current targeted testing and prevention strategies for pregnant women and facilitate timely linkage to care.”
Taveras J, Trepka MJ, Madhivanan P, Gollub EL, Dévieux JG, and Ibrahimou B. HIV risk and testing behaviors among pregnant women tested for HIV in Florida by site type, 2012 [published online February 4, 2019]. Women & Health. doi: 10.1080/03630242.2019.1565902